Speech Impairment - Adults

Speech and language impairment may be any of several problems that make it difficult to communicate.


Common speech and language disorders include:


APHASIA

Aphasia is loss of the ability to understand or express spoken or written language. It commonly occurs following strokes or traumatic brain injuries. It can also occur in people with brain tumors or degenerative diseases that affect the language areas of the brain. This term does not apply to children who have never developed communication skills. There are many different types of aphasia.

In some cases of aphasia, the problem eventually corrects itself, but in others the condition does not get better.


DYSARTHRIA

With dysarthria, the person has ongoing difficulty expressing certain sounds or words. They have poorly pronounced speech (such as slurring) and the rhythm or speed of speech is changed. Usually, a nerve or brain disorder has made it difficult to control the tongue, lips, larynx, or vocal cords, which make speech.

Dysarthria, which is difficulty pronouncing words, is sometimes confused with aphasia, which is difficulty producing language. They have different causes.

People with dysarthria may also have problems swallowing.


VOICE DISTURBANCES

Anything that changes the shape of the vocal cords or the way they work will cause a voice disturbance. Lump-like growths such as nodules, polyps, cysts, papillomas, granulomas, and cancers can be to blame. These changes cause the voice to sound different from the way it normally sounds.


Causes

Some of these disorders develop gradually, but anyone can develop a speech and language impairment suddenly, usually in a trauma.

1) APHASIA

  • Alzheimer Disease
  • Brain tumor (more common in aphasia than dysarthria)
  • Dementia
  • Head trauma
  • Stroke (CVA)
  • Transient ischemic attack (TIA)

2) DYSARTHRIA

  • Dementia
  • Diseases that affect nerves and muscles (neuromuscular diseases), such as amyotrophine lateral sclerosis (ALS or Lou Gehrig disease), cerebral palsy, myasthenia gravis, or multiple sclerosis (MS)
  • Facial trauma
  • Facial weakness, such as Bell's Palsy or tongue weakness
  • Head Trauma
  • Head and neck cancer surgery
  • Nervous system (neurological) disorders that affect the brain, such as Parkinson Disease or Huntington Disease (more common in dysarthria than aphasia)
  • Poorly fitting dentures
  • Side effects of medications that act on the central nervous system.
  • Stroke (CVA)
  • Transient Ischemic Attack (TIA)

3) DYSPHAGIA

  • Dysphagia is defined as a decreased ablilty to chew and/or swallow food, liquid, or saliva; structures include the lips, tongue, teeth, mouth, throat, and esophagus; can be the result of stroke, brain injury, surgery, neurological disease, or injury to the throat. 
  • Aspiration is defined as food/liquid that enters the airway, passes through the vocal folds, and may continue to travel downward to the lungs; should trigger a significant cough response; if no cough is produced, then it is called silent aspiration, must be prevented as it may lead to aspiration pneumonia

   Signs and Symptoms of Dysphagia and Aspiration

  • Eyes Watering
  • Nasal Drip
  • Redness of Face
  • Change in Respiration Rate
  • Difficulty or Inability To Breathe
  • Gurgly Voice Quality
  • Spiked Fever
  • Coughing and Choking
  • Gagging
  • Chest Pain
  • Unexplained Weight Loss
  • Refusal To Eat

4) VOICE DISTURBANCES

  • Growths or nodules on the vocal cords
  • People who use their voice heavily (teacher, coach, instructor pilot) are more likely to develop voice disorders.

When to Contact a Medical Professional

Contact your health care provider if:

  • Impairment or loss of communication comes on suddenly.
  • There is any unexplained impairment of speech or written language.